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The treatment of psoriatic arthritis aims at controlling the inflammation of the joint.
The treatment of psoriatic arthritis aims at controlling the inflammation of the joint. The first-line therapy differs in psoriatic arthritis as per severities. In mild psoriatic arthritis, the mainstay of treatment includes anti-inflammatory agents such as nonsteroidal anti-inflammatory drugs (NSAIDs). Apart from NSAIDs, the following drugs are also effective as a first-line treatment for mild psoriatic arthritis:
- Low-dose prednisone given orally
- Glucocorticoid injection
According to the National Psoriasis Foundation and American College of Rheumatology, a biologic agent (tumor necrosis factor alpha [TNF-α] inhibitors) is effective as a first-line treatment in people with active psoriatic arthritis. Additionally, the physician may recommend other disease-modifying antirheumatic drugs (DMARDs) for active psoriatic arthritis.
However, the physician may prescribe a combination of DMARDs or biologics in people with severe psoriatic arthritis and joint damage.
NSAIDs:
When the arthritis is mild, the doctor usually prescribes NSAIDs. NSAIDs prohibit inflammatory reaction. Some of the most common NSAIDs include:
Moreover, your doctor might prescribe misoprostol and omeprazole to prevent the unwanted effects of NSAIDs.
DMARDs:
If arthritis doesn’t respond to NSAIDs, the doctor may prescribe DMARDs to stop
- Severe pain.
- Joint swelling.
- Joint and tissue damage.
DMARDs are potent than NSAIDs and may take longer to work. The most commonly used DMARDs include:
Immunosuppressants:
If DMARDs do not work for you, there’s another option called immunosuppressants. As the name suggests, these drugs suppress the hyperactive immune system. Some of the immunosuppressants effective against psoriatic arthritis include:
Biologics:
Another option to treat psoriatic arthritis involves biologics. They are the latest version of DMARDs with a slight alteration in their mechanism of action. Unlike DMARDs, which target your entire immune system, these medications block a specific protein causing inflammation. They include:
- Abatacept
- Adalimumab
- Apremilast
- Certolizumab pegol
- Etanercept
- Golimumab
- Guselkumab
- Infliximab
- Ixekizumab
- Secukinumab
- Tofacitinib
- Ustekinumab
Topical medications:
Most people with psoriatic arthritis experience itching as an associated symptom. Psoriatic itch is characterized by burning or biting on the skin.
Some of the topical medications that work effectively against psoriatic itch include:
- Topical steroid such as hydrocortisone
- Calamine lotion
- Camphor
- Benzocaine
There are other prescription options if these seem to be ineffective:
- Antihistamines
- Steroids
- Capsaicin
- Topical anesthetics
Steroids:
Corticosteroids are potent anti-inflammatory drugs that relieve severe pain and swelling. There are two ways to take steroids:
- By mouth
- Inject them directly into the joint or muscle
Prednisone is the most common steroid prescribed for psoriatic arthritis.
What are some of the lifestyle changes to be made by people with psoriatic arthritis?
You can make some lifestyle changes to improve the quality of life after getting psoriatic arthritis:
- Try reducing weight if you are obese and try to lead a healthy lifestyle.
- Avoid alcohol or at least reduce the intake to prevent relapse.
- Getting natural sunlight can help diminish the effects of psoriatic arthritis.
- The Mediterranean diet or a gluten-free diet has proved to be beneficial in reducing the symptoms.
- Stay away from food that may trigger inflammation such as:
- Fatty red meat
- Processed food
- Refined sugar
- Dairy products
- Rest as much as possible.
- Avoid stressing out to prevent exacerbations of the condition.
- Go for regular checkups to know about disease progression.
- Refrain from smoking.